Men who identify themselves as heterosexual are three times more likely to categorize bisexuality as not a legitimate sexual orientation, an attitude that can encourage negative health outcomes in people who identify as bisexual, according to an analysis led by University of Pittsburgh Graduate School of Public Health researcher Mackey Friedman, Ph.D., M.P.H.

Men who identify themselves as heterosexual are three times more likely to categorize bisexuality as “not a legitimate sexual orientation,” an attitude that can encourage negative health outcomes in people who identify as bisexual, according to an analysis led by University of Pittsburgh Graduate School of Public Health researcher Mackey Friedman, Ph.D., M.P.H.

The results of the survey, sponsored by the Indiana University Bloomington, will be presented today at the American Public Health Association’s 141st Annual Meeting & Exposition in Boston.

“Bisexual men and women face prejudice, stigma and discrimination from both heterosexual and homosexual people,” said Dr. Friedman, director of Project Silk, an HIV prevention initiative. “This can cause feelings of isolation and marginalization, which prior research has shown leads to higher substance use, depression and risky sexual behavior. It also can result in lower rates of HIV testing and treatment.”

Building on previous work assessing attitudes toward bisexual men and women, Dr. Friedman and his colleagues surveyed hundreds of adult college students for words that come to mind in relation to bisexual people, such as “confused,” “different” and “experimental.” The researchers then developed a 33-question survey and administered it to an online sample of 1,500 adults.

Overall, respondents were generally negative in terms of their attitudes toward bisexual men and women, with almost 15 percent of the sample in disagreement that bisexuality is a legitimate sexual orientation. However, women, white people and people who identified themselves as lesbian, gay or bisexual had less bias and prejudice against bisexual people. Of note, respondents who identified as gay or lesbian responded significantly less positively toward bisexuality than those identifying as bisexual, indicating that even within the sexual minority community, bisexuals face profound stigma. In addition, these findings indicate that male bisexuals likely suffer more stigma than female bisexuals.

Dr. Friedman explains that when a bisexual person perceives that his or her sexual orientation is not recognized by peers, it can cause the person to feel socially isolated and unable to talk openly with friends, family and school mates.

“Having hard data to back up why a bisexual person might feel the need to be secretive about sexual orientation, something that can lead to higher depression and many other negative health outcomes, is very useful to people trying to fight stigma and marginalization,” said Dr. Friedman. “For example, this information can guide social marketing interventions and outreach to reduce that stigma, and improve rates of HIV prevention, testing and treatment within the bisexual community.”